Summary / Overview

As the Veterans Health Administration (VHA) expands the capabilities of its personal health record
system, My HealtheVet (MHV), and places greater emphasis on encouraging its use, it is interested
in understanding how best to prioritize different functionalities and which of them will provide
the greatest benefits to Veterans. This systematic review was designed to evaluate the literature
surrounding secure messaging systems and electronic applications that give patients access to their
own medical records, specifically investigating the evidence that these systems improve health
outcomes, patient satisfaction, healthcare utilization and efficiency, and adherence. Additionally,
the review examined studies that evaluated attitudes, particularly regarding patients having online
access to their own medical information. The review distinguished between electronic systems that
were "tethered" or tied to existing healthcare institution systems similar to how MHV is tethered to
VHA's EHR, versus those that were "stand-alone."

The Key Questions were:

Key Question #1: What is the association between secure messaging and health outcomes,
patient satisfaction, adherence, efficiency or utilization, or automated email?Key Question #2: What is the association between patient access to their own medical record
and health outcomes, patient satisfaction, adherence, efficiency or utilization, and attitudes about
access?